CARC 23OA · Other Adjustment
This adjustment reflects how a prior payer already processed the claim, reducing what this payer pays as a result.
- Common causes
- Used on secondary or tertiary claims, where the primary payer's payment and adjustments are being factored into this payer's processing.
- Suggested fix
- This is typically informational for coordination-of-benefits processing; verify the primary payer's EOB amounts were reported correctly on the secondary claim.
Related Other Adjustment codes
109This payer isn't responsible for this claim; it needs to be sent to a different payer or contractor.136The claim wasn't processed correctly because it didn't follow the rules or requirements set by a prior (primary) payer.140The member ID number submitted doesn't match the patient or subscriber name on file with the payer.18This claim or service line is an exact duplicate of one already submitted and processed.19The payer has determined this claim relates to a work injury or illness, making workers' compensation the responsible party instead.215Payment was adjusted based on a third-party settlement where the payer has subrogation rights to recover costs.22The payer believes another insurance plan should be billed first or is otherwise responsible under coordination-of-benefits rules.253Payment was reduced due to mandatory federal budget sequestration, a government-wide across-the-board cut applied to Medicare payments.
Frequently asked questions
What does CARC 23 mean?
This adjustment reflects how a prior payer already processed the claim, reducing what this payer pays as a result.
How do I resolve CARC 23?
This is typically informational for coordination-of-benefits processing; verify the primary payer's EOB amounts were reported correctly on the secondary claim.
Why does CARC 23 happen?
Used on secondary or tertiary claims, where the primary payer's payment and adjustments are being factored into this payer's processing.
CARC codes maintained by X12 (x12.org). Descriptions on this site are original reference interpretations. Always verify codes with authoritative sources before making billing decisions.